Periodontal disease is an inclusive term used to describe an inflammatory condition of the gums (gingivitis) and/or support structures (periodontitis). The periodontal disease path typically progresses from gingivitis to periodontitis.

Periodontal disease may be a manifestation of a more systemic condition, such as diabetes, anemia, vitamin deficiency states, leukemia or other disorders of white blood cell function. In addition, it is associated with hardening of the arteries (atherosclerosis) and an elevation in C-reactive protein (CRP) -- which is an important marker for systemic inflammation and an independent risk factor for heart disease.

Long-chain omega-3 fatty acids EPA and DHA found in fish and fish oil supplements have been shown to be protective against atherosclerosis, as well as being useful in the treatment of a wide range of inflammatory mediators. It seems only natural that a recent double-blind study would show significant benefit with fish oil supplementation in patients with periodontal disease.

Background Data

In addition to proper oral hygiene, the therapeutic goals in treating periodontal disease from a natural medicine perspective are:

Decrease wound healing time (the timespan for wound healing is longer in patients who are more susceptible to periodontal disease).

Although there are many nutritional considerations in the goals listed above, supplementation with fish oils would appear warranted based upon the possibility of achieving some of these goals -- especially the ability to reduce inflammation.

New Data

Sixty otherwise healthy subjects with moderate and severe chronic periodontitis were enrolled in a double-blind, placebo-controlled trial to test the ability of fish oil supplementation to improve this condition. The control group was treated with the standard dental treatment of scaling and root planing (SRP) and given a placebo; the treatment group was treated with SRP and dietary supplementation of omega-3 fatty acids (providing 180 mg of EPA and 120 mg DHA daily for 12 weeks).

A significant reduction in the gingival index, sulcus bleeding index, pocket depth, and clinical attachment level was found in the treatment group compared to the control group at the 12-week exam. However, no statistically significant changes in serum CRP levels were found.

The pocket depth improved from 4.26 mm at baseline to roughly half that value at 2.15 mm. These results show that fish oil supplementation is very much indicated in the treatment of periodontal disease.

Commentary

These results are impressive given the rather modest dosage of EPA+DHA. For general health the standard recommendation is to take enough of a fish oil supplement to provide a total of 1,000 mg EPA+DHA. For therapeutic purposes, the usual dosage is 3,000 mg EPA+DHA daily.

A higher dosage of EPA+DHA may be necessary to lower CRP levels, a key marker in systemic inflammation.

For more information on natural approaches to periodontal disease, please consult the 3rd edition of The Encyclopedia of Natural Medicine.

Dr. Michael T. Murray is one of the world's leading authorities on natural medicine and the author of more than 30 bestselling books, including The Encyclopedia of Natural Medicine. He is a graduate and former faculty member, and serves on the Board of Regents, of Bastyr University in Seattle, Washington.